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Department: MEANE-Anesthesiology
Course: 425-Anesthesiology Sub-Internship
Track:

Course Coordinator: Dr. Crystal C. Wright
Course Faculty: Dr. Crystal C. Wright,Dr. Alice Oswald
Elective Location: BTGH
Periods Elective offered:
Min. Number of Students:Max: 2
Course Level: Clinical Elective: Counts toward 32-credit graduation requirement
Credit: 8
Pre-requisites: Medicine or Surgery Core
Visiting Student Elective: Yes
Open to International Students: Yes
Grading: Pass/Fail Only
Faculty Approval: Yes

Time Commitment Percentage of time expected
Regular Hours (Mon-Fri): 6:30am - 4:30pm Inpatient Ward:
Night Call: Yes Inpatient consultations:
Number on-call nights: Outpatient clinics:
Weekends: Yes Surgery:
    Laboratory
  Didactic:
  Other:
Statement of Goals:
OPTION 1 (BTOR): Ben Taub General Operating Rooms (BTORs) with a focus on Cardiothoracic Anesthesia, Neuroanesthesia, Trauma Anesthesia, and Regional/Pain Medicine. OPTION 2 (BTOB): Ben Taub Obstetrical Anesthesia and Gynecological operating rooms with focus on Obstetrical Anesthesia, Gynecological Anesthesia, and Advanced Airway Management. Upon completion of the acting internship the student should be able to fulfill the following goals for both Rotation Option 1 and 2: 1. Perform a preoperative evaluation according to the patient's medical condition. 2. Understand the pharmacology of induction agents and differentiate the induction agents needed to care for a cardiac, trauma, obstetrical or neuroanesthesia patient. 3. To become familiar with basic airway management skills including mask ventilation and endotracheal intubation. 4. To become proficient in the placement of peripheral intravenous lines. 5. To understand the role anesthesiologists play in preventing intraoperative and postoperative adverse events with preoperative evaluation; monitoring; positioning; warming and fluid balance; and overall patient safety for good outcomes. OPTION 1 ROTATION GOALS: To become familiar with standard ASA monitors and indications for invasive cardiovascular monitoring techniques. To be able to state the determinants of myocardial oxygen supply and demand and understand the difference in basic anesthetic management of patients with coronary artery disease and valvular disease. To appropriately evaluate a patient presenting for regional anesthesia. To understand and state the landmarks for basic upper and lower extremity regional blocks. To understand basic neurophysiology including but not limited to understanding determinants of cerebral blood flow. OPTION 2 ROTATION GOALS: To become familiar with anesthetic concerns for the obstetric patient and indications for neuraxial anesthesia (spinal, epidural, combined spinal-epidural) vs. general anesthesia vs. monitored anesthetic care with IV/inhaled anesthesia. To understand the postoperative evaluation of a patient that has had a neuroaxial anesthesia and the management of postdural puncture headache, backpain, and neuropathies that may be attributed to receiving anesthetic care for obstetrics. To better recognize a potentially difficult airway and become familiar with the variety of available advance airway devices by observing their use in securing the airway.
Learning Activities
DIDACTIC LECTURE REQUIREMENTS: a. The student rotation on options 1 & 2 will be required to attend the Department of Anesthesiology Grand Rounds on Wednesdays at 6:30am at BCM M112 DeBakey Building. b. The student rotating on option 1 will be required to attend the general first year Anesthesiology Resident lectures on Mondays & Wednesdays at 4:00pm at Ben Taub General Hospital. c. The student rotating on option 2 will be required to attend the Obstetrics, Gynecological, and Perinatal Anesthesiology didactic lecture series on Tuesday afternoons and Wednesdays morning. PRESENTATION REQUIREMENTS: To enhance the intraoperative learning experience, the student will be required to develop a case presentation. This presentation will be focused on anesthesia and co-existing diseases. The student will have the opportunity to present a 10 minute PowerPoint presentation based on a case that the student was involved in. The required components of the presentation will include preoperative, intraoperative, and postoperative care of the patient and a discussion of the co-existing disease that was associated with anesthetic care of the patient. This topic will be discussed with Dr. Wright or Dr. Oswald prior to selection. They will also be available to assist the student in completing the presentation. SKILLS ASSESSMENT LOG: The student will be required to keep a log of skills performed during the rotation that will need to be signed off by an attending anesthesiologist. FOR OPTION 1: A minimum of 5 successful intravenous catheter placements, 2 mask ventilations, and 1 successful enotracheal intubation. Documentation of witnessing and involvement of the placement of a minimum of 1 arterial lines, 1 central lines, and 1 pulmonary artery catheter. FOR OPTION 2: A minimum of 5 successful peripheral IVs placed, demonstration of 2 adequate mask ventilations, 1 successful endotracheal intubation, placement of 1 spinal anesthetic for post-partum bilateral tubal ligation (ppBTL), and placement of 1 labor epidural.
Evaluation Methods
Students will be given daily feedback by the attending that they work with regarding their performances for the day. In addition to verbal feedback, the student's grade will be based on daily attendance at required lectures and grand rounds, quality of end of the rotation presentation, and maintenance of skills assessments log book. The grading system will be H, HP, P, MP, F.
When and Where to report on first day of service:
Option 1 Students report at 8 am to Oscar Porter or Cealy Browder on 4th fl. BTGH in scrubs (call 713-873-2860 for assistance). Option 2 students report at 6:50 am to BTOR Anesthesiology lounge on 3rd fl. Section 3F BTGH (Call 713-873-2900 or 713-873-2905 for assistance).
For additional information regarding this elective contact:
Contact Name: Annette Brieno
Contact Phone: 713-798-1887
Contact Fax: 713-798-6374
Contact Location: 1700 Dryden Road, Suite 700
Address: BCM-120
Email: abrieno@bcm.edu
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